Active NPI
Teresa Estrada, MA, SLP
- Speech-Language Pathologist
- Kenosha, WI
National Provider Identifier
1669625570
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 3164-154
- Practice address
- 3415 Sheridan Road
Woodstock
Kenosha, WI 53140-1924 - Phone
- (262) 657-6175
- NPI assigned
- Oct 23, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 3164-154 | WI | Primary |
Addresses
Primary practice location
3415 Sheridan Road
Woodstock
Kenosha, WI 53140-1924
Mailing address
3415 Sheridan Road
Woodstock
Kenosha, WI 53140-1924
Phone (262) 657-6175
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3164-154 | WI | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1224720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1224720000000",
"number": "1669625570",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3415 SHERIDAN ROAD",
"address_2": "WOODSTOCK",
"city": "KENOSHA",
"state": "WI",
"postal_code": "531401924",
"telephone_number": "262-657-6175"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3415 SHERIDAN ROAD",
"address_2": "WOODSTOCK",
"city": "KENOSHA",
"state": "WI",
"postal_code": "531401924",
"telephone_number": "262-657-6175"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ESTRADA",
"first_name": "TERESA",
"credential": "MA, SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-10-23",
"last_updated": "2008-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "WI",
"license": "3164-154",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kenosha, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.